HomeMy WebLinkAbout0098702-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
834 ECKARDT CT
TENTH STREET STATION INC
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas I [] Oil
[] New j
L~J Forced Air I L-J Radiant
Electric ] ~ Hot Water I
Chimney Type ~ Chimney A ~ Chimney B
Heat Loss ~) As Approved ~1~ Existing
BTU Rate ~ As Per Plan ~ Variable
Owner CLYDE M SIBLEY
Category 500- Residential-Heating & Ventilating
[~-ectdc 1 ~--S~ar
[] Replace I
~ Steam I L_I NC
LJ Suppl. t ~ Con. Burner
Direct Vent (...) Not Applicable
Not Applicable I Value
Other I Value
No
Create Date
Plan
[] Other
98702
11/19/2002
Vent
Use/NatUre SFPJ Replace furnace. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued BY:
$2,329.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided I
$41.00
Date 11/19/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
AddresS 924 OHIO STREET OSHKOSH WI 54902 -0 ~ TelephOne Number 236-8770
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled o:
normal permit fee, which ever is greater.
OR
[£¥ou are a contractor participating in the Permit~e Account System and have adequate fu
(['you want this processed through your account
JOB )RESS
CHECK [] ALL APPLICABLE
USE CATEGORY
[~ingle Family IZIDuplex
nMulti-Family
[2]Rental [2Commercial mind
FUEL 't~lGas VIElectric DS~lid
mOil [2]Solar
SYSTEM F1New I~q. eplacc
[2]Other
TYPE
~Forced Air []Radiant F1Steam []AJC []Vent []Electric
IS CHIMNEY BEING LINED rqNo 15~Yes - LINER SIZE td ~ t
Note: All chimneys shall be sized per the BTU's being vented.
[]Hot Water VISuppl. r-lc,
& MANUFACTURER .~sLY~X[ Li so:e.L'-tv_
CHIMNEY TYPE F1Chimney A V1Chimney B [5~Direct Vent I--IOther
HEAT LOSS nas Approved []Existing lqNot Applicable
BTU RATE nAs Per Plan FIVariable [] Other Value
ALL WORK BEING DONE
DESCRIPTION
OF
VALUE (Including labor and all materials including light fixtures) $ 7.-~ ZO: cPO ¢(~ ~
' ~,For applicable projects, an Electric Installation Verification form, s~gned by the Electrical
attached. If not attached or not applicable, a separate Electrical Permit is required.
, ~11/]9/2802 88:3~ 9207272133 MINERGY P&GE 0~
: (we)
Electric Installation Verification
(Electrical Contraclor Nzmae)
(Address) (City) (State) (Zip Code)
have 'been comracted to perlbrm electric installation work for 1 *0 -t-.g ~."::~..r...3, :.:.
~,~ 0Xfame °f party c°ntracted t°)
(Addrms where work will be performed.)
The nature of the work consists of: (Check One or Describe the Nature of Work)
"/. Reconnection or new circuit for replacement Heating Pla:it an&/or A/C Condenser.
~ Recormection or new circuit for replacement Electric Water Heater or power vented
wat~ heater.
Recormection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding/soffit i~stallatiom Note: New Service
Entrmme Cables will require a separate p~n'lit,
.... Reconnection or new circuit for the replacement of other permanently w/red
appliancez / fix.tures,
New circuit for the addition of A/C to an indi¥iduM dwelling unfl (house or the
individual systems in a duplex or condominium.), incl. ud/ng required service
electrical outlets.
Other
The value of this work is $~* ....... .
I hereby verify t. his work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements,
(Print Name of Officer)
,,,
(Date)
5/02